Partnerships for capacity building: community, governments and universities working together

This paper summarises initiatives in the area of capacity building between communities, governments and universities since Rio 1992.

First the global advances through the UN and associated agencies are described with lessons learned and challenges remaining being highlighted. This is followed by a similar approach for first regionally based initiatives and finally some of the better examples of nationally based approaches.

Among the key findings from the review were: trying to keep the initial message simple, asking the “user” what they want and what they need from capacity building, the use of local experts in capacity building where ever possible, universities extending themselves to engage in genuine partnerships as well as offering new courses, subjects, etc., attempting to match the strengths and weaknesses of partners in capacity building, concentrating on improving regional partnerships across national boundaries, deriving methods to sustain capacity building programs over the long term, questioning the absence of the private sector from capacity building partnerships, questioning whether capacity building is receiving the attention, funding and centrality to ICM promotion that it warrants, a proposal to build a global ICM capacity building network, the need for greater critical analysis of capacity building programs, integrating capacity building into ICM practices and recognising that effective capacity building practice may require some time and effort to build up, i.e. there are no universal “quick-fixes”.

Straddling the pathway from paediatrician to mainstream health care : transition issues experienced in disability care

Objective: To identify the strengths and limitations of health care and related services provided to young adults with a disability during the period of transition from the care of a paediatrician to the mainstream health system.
Design: A descriptive design was used to address the study objectives.
Setting: Barwon and south-western region of Victoria.
Subjects: Twelve focus group discussions, with young adults with a disability, carers of young adults with a disability and health care service providers. Each focus group involved eight to 10 participants.
Results: The findings revealed a number of problems with the transition period. All participants acknowledged the supportive, coordinating role of the paediatrician. In the absence of this type of role, carers felt they lacked the knowledge and support to manage the adolescent with a disability. Communication problems between all service providers were identified as being problematical. The general lack of continuity of care between providers made it difficult for individuals to negotiate the transition period and increased the burden of care on carers.
Conclusion: There is a need for policy makers to address these transition problems and develop appropriate services that improve the situation for young adults with a disability and their carers.
What is already known: It is well documented that the transition period from paediatrician to adult health care services is problematic for the young adult with a disability and their carer. The difficulties experienced are attributed to poor communication between service providers and a lack of continuity of care.
What does this study add: This study provides insights from a number of different consumer and health care professionals' perspectives. The findings identify service delivery gaps and a need to develop health care services that could assist the young adult with the disability negotiate this transition from the paediatric services to mainstream health care services in rural and regional settings in Victoria.

Survey of canteens and food services in Victorian schools

Objective: To examine the characteristics of food services in Victorian government primary and secondary schools.

Design and methods: A cross-sectional postal survey of all high schools and a random sample of one quarter of primary school respondents in Victoria. A `School Food Services and Canteen' questionnaire was administered by mail to the principal of each school.

Subjects: Respondents included principals, canteen managers and home economics teachers from 150 primary and 208 secondary schools representing response rates of 48% and 67%, respectively.

Main outcome measures: Responses to closed questions about school canteen operating procedures, staff satisfaction, food policies and desired additional services.

Data analyses: Frequency and cross-tabulation analyses and associated χ²-tests.

Results: Most schools provided food services at lunchtime and morning recess but one-third provided food before school. Over 40% outsourced their food services, one-third utilised volunteer parents, few involved students in canteen operations. Half of the secondary schools had vending machines; one in five had three or more. Secondary school respondents were more dissatisfied with the nutritional quality of the food service, and expressed more interest in additional services than primary respondents. Schools with food policies wanted more service assistance and used volunteer parents, student and paid canteen managers more than schools without policies.

Conclusion: Most schools want to improve the nutritional quality of their food services, especially via school food policies. There is a major opportunity for professional organisations to advocate for the supply of healthier school foods.

Digital TV in Australia and the USA: a cross-impact analysis of the adoption and diffusion of digital TV in Australia and the United States

The paper examines the adoption and diffusion of Digital Television (DTV) in Australia and the United States, identifying historical, technical, regulatory, marketing, and other commonalities and differences that appear to be most significant to its adoption, as both countries have experienced a 'sluggish' diffusion and adoption of DTV so far. Using library research and borrowing the cross-impact matrix method from futures research, the authors develop J J events related to the various influences and groups of stakeholders that had shaped the policy making and adoption of DTV. We then carry out a comparative analysis between the two countries to make evident their impacts, strengths, and directions of influence. The authors suggest that the implementation of DTV in these two developed countries appears to be nearly identical. Even though Australian and US broadcasting models are fundamentally different, the diffusion process for DTV is primarily affected by the nature of digital technology and globalisation, two trends that may be diminishing the import of the nation-state in the technology adoption process. The paper concludes that these broader economic and technical events may have greater import to DTV's successful diffusion than do traditional, cultural, and nationalistic factors suggested in earlier comparative broadcast studies.

The relationship between social anxiety and alcohol use in remand prisoners

Community studies have found a consistently high co-occurrence, between alcohol use and anxiety disorders, such as social phobia. Despite high prevalence rates of alcohol use and anxiety disorders in remand prisoners, the extent to which they co-occur in this population and the use of alcohol as a strategy to reduce social anxiety, have not been examined. The aim of this study was to assess levels of social phobia and the use of alcohol to reduce anxiety associated with social and performance situations in a remanded prison population. One hundred and one male prisoners (age M = 34.88 years, SD = 11.70) participated in the study. They completed the Social Phobia Inventory (SoPhI) and a questionnaire designed to assess levels of drinking in social and performance situations to reduce anxiety. High levels of social anxiety were found, together with high levels of drinking to reduce anxiety associated with social or performance situations. Drinking was predictive of reduced levels of social anxiety but the effect of social anxiety on drinking was stronger. The implications for treatment and future research are discussed.

Puberty and the onset of substance use and abuse

Objective: Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.

Methods: The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).

Results: The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4–2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4–4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0–1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7–3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2–3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2–5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.

Conclusions: Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.

Stigmatization of AIDS patients : disentangling Thai nursing students' attitudes towards HIV/AIDS, drug use and commercial sex

This paper analyzes the interrelationships between the stigma of HIV/AIDS stigma and the co-stigmas of commercial sex (CS) and injecting drug use (IDU). Students of a Bangkok nursing college (N = 144) were presented with vignettes describing a person varying in the disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU, CS, blood transfusion, no co-characteristic). For each vignette, participants completed a social distance measure assessing their attitudes towards the hypothetical person portrayed. Multivariate analyses showed strong interactions between the stigmas of AIDS and IDU but not between AIDS and CS. Although AIDS was shown to be stigmatizing in and of itself, it was significantly less stigmatizing than IDU. The findings highlight the need to consider the non-disease-related stigmas associated with HIV as well as the actual stigma of HIV/AIDS in treatment and care settings. Methodological strengths and limitations were evaluated and implications for future research discussed.

Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature

Preventing the development of obesity in children is an international health priority. To assess the effectiveness of interventions designed to prevent obesity, promote healthy eating and/or physical activity and/or to reduce sedentary behaviours in 0–5-year-old children, a systematic review of the literature was performed. Literature searches were limited to articles published between January 1995 and June 2006, printed in English and sampling children aged 0–5-years. Searches excluded literature concerned with breastfeeding, eating disorders, and interventions which were school-based or concerned with obesity treatment. Two reviewers independently extracted data and assessed study strengths and weaknesses. Nine included studies were grouped based on the settings in which they were delivered. Most studies involved multi-approach interventions, were conducted in the USA and varied in study designs and quality. All showed some level of effectiveness on at least one obesity-behaviour in young children. These studies support, at a range of levels, the premise that parents are receptive to and capable of some behavioural changes that may promote healthy weight in their young children. The small quantity of research heralds the need, particularly given the potential for early intervention to have long-lasting impacts on individual and population health, to build in a substantial way upon this evidence base.

Personality, behavioural and affective characteristics of hazardous drinkers

The aim of this study was to investigate the influence of appetitive and aversive motivation on hazardous drinking behaviour by drawing on Reinforcement Sensitivity Theory (RST). A between-groups design examined differences between hazardous drinkers and matched controls on self-report and behavioural appetitive and aversive motivation. The relationship between motivational processes and changes in affective states following behavioural task performance was also examined. Data from 27 hazardous drinkers (M = 21.88 years, SD = 3.29) and 27 gender and age matched controls (M = 21.85 years, SD = 4.08) were utilised. The Card Arranging Reward Responsivity Objective Test (CARROT) assessed behavioural appetitive motivation and the computerised Q-TASK provided an index of behavioural aversive motivation. Self-report appetitive and aversive motivation was measured using the Sensitivity to Punishment and Reward Questionnaire (SPSRQ). Brief scales tapping state positive and negative affect were also administered. Hazardous drinkers were significantly higher than controls on self-report but not behavioural measures of appetitive motivation. Results also indicated that hazardous drinkers reported significantly higher levels of negative affect. These data suggest that hazardous drinkers are characterised by high trait appetitive motivation and state negative affect. It was suggested that RST may provide a useful framework for understanding both the appetitive and aversive motivational processes involved in drinking behaviour.

Dissecting obesogenic behaviours: the development and application of a test battery for targeting prescription for weight loss

There are limited practical tools to help clinicians or public health workers manage obesity in their patients. We have previously developed a scanning technique for diagnosing environments leading to obesity (Analysis Grid for Environments/Elements Leading to Obesity). Here we describe the development of a tool for identifying behaviours in an individual most likely to lead to obesity. A questionnaire battery of five tests called the DAB-Q (Diet, Activity and Behaviour Questionnaire) was developed, piloted and internally validated with overweight women from a commercial weight loss programme. Outcome from the tests, which are available free on the Internet, provides clinicians with a simple, effective and time-saving tool for ranking foods, drinks and activities likely to be most effectively targeted for weight loss in an individual. This is based on total scores derived from measures of frequency, potential for change and potency of each item as a potential contributor to overweight.

Concepts and dimensionality in modeling unsaturated water flow and solute transport

Many environmental studies require accurate simulation of water and solute fluxes in the unsaturated zone. This paper evaluates one- and multi-dimensional approaches for soil water flow as well as different spreading mechanisms to model solute behavior at different scales. For quantification of soil water fluxes,Richards equation has become the standard. Although current numerical codes show perfect water balances, the calculated soil water fluxes in case of head boundary conditions may depend largely on the method used for spatial averaging of the hydraulic conductivity. Atmospheric boundary conditions, especially in the case of phreatic groundwater levels fluctuating above and below a soil surface, require sophisticated solutions to ensure convergence. Concepts for flow in soils with macro pores and unstable wetting fronts are still in development. One-dimensional flow models are formulated to work with lumped parameters in order to account for the soil heterogeneity and preferential flow. They can be used at temporal and spatial scales that are of interest to water managers and policymakers. Multi-dimensional flow models are hampered by data and computation requirements.Their main strength is detailed analysis of typical multi-dimensional flow problems, including soil heterogeneity and preferential flow. Three physically based solute-transport concepts have been proposed to describe solute spreading during unsaturated flow: The stochastic-convective model (SCM), the convection-dispersion equation (CDE), and the fraction aladvection-dispersion equation (FADE). A less physical concept is the continuous-time random-walk process (CTRW). Of these, the SCM and the CDE are well established, and their strengths and weaknesses are identified. The FADE and the CTRW are more recent,and only a tentative strength weakness opportunity threat (SWOT)analysis can be presented at this time. We discuss the effect of the number of dimensions in a numerical model and the spacing between model nodes on solute spreading and the values of the solute-spreading parameters. In order to meet the increasing complexity of environmental problems, two approaches of model combination are used: Model integration and model coupling. Amain drawback of model integration is the complexity of there sulting code. Model coupling requires a systematic physical domain and model communication analysis. The setup and maintenance of a hydrologic framework for model coupling requires substantial resources, but on the other hand, contributions can be made by many research groups.

Survey commentaries and analysis on SWOT analysis of Singapore biotechnology boom indicators

The article presents survey commentaries and analysis on Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis of biotechnology boom indicators in Singapore as of April 2006. SWOT is the process whereby the strengths and weaknesses in the internal environment are analyzed in association with the opportunities and threats arising from the external environment. The success of Singapore's biotechnology sector depends on the effectiveness and efficiency of the interface between the external and internal environments. The strengths, weaknesses, opportunities, and threats in the industry are discussed.

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

Role play in blended learning : a case study exploring the impact of story and other elements

Role play is an increasingly popular technique in tertiary education, being student centred, constructivist and suitable for a range of subject areas. The choice of formats is wide open, with options ranging from the traditional face to face performance through to multi-user online computer games. Some teachers prefer to take advantage of features of both online and face to face formats and offer a blended form. This case study describes an innovative blended role play in which the online component plays a small but important part. The findings show that decisions on not only how to make the best use of technology but also how to design and facilitate a role play can have a profound effect on the creation of an engaging first-person story from which powerful learning can be drawn—in this case, learning outcomes including deep insights into strengths and weaknesses of participants' personal change management styles.

New techniques and issues in assessing walking behavior and its contexts

In the first section of this article, we discuss the metabolic responses to walking by describing the economy of walking during different locomotion velocities. Gender, weight status, and growth effects on metabolic responses to walking are reviewed. In the second section, we examine the use of technology to assess walking patterns and behavior in the community. We use an engineering approach for understanding how to measure objects that move, and these methods are used to assess walking used in transportation. In the third part of the paper, we summarize self-report methods that have been used to assess walking behavior and highlight the strengths and weaknesses of these methods. We illustrate how self-report methods are used to quantify walking behavior in the surveillance systems that are now widely used to ascertain walking prevalence and temporal changes in different populations. In the final section, we discuss ways of measuring the walkability of neighborhoods and the community to understand the influence of the built environment on walking behavior.